Provider Demographics
NPI:1700944618
Name:TOPONCE, NEDRA (LMFT)
Entity Type:Individual
Prefix:
First Name:NEDRA
Middle Name:
Last Name:TOPONCE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 BROOKSIDE DR.
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404
Mailing Address - Country:US
Mailing Address - Phone:208-538-0676
Mailing Address - Fax:208-523-1541
Practice Address - Street 1:144 BROOKSIDE DR.
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404
Practice Address - Country:US
Practice Address - Phone:208-538-0676
Practice Address - Fax:208-523-1541
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID4228106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist